Download PDF
Psychother Psychosom Med Psychol 2000; 50(7): 274-286
DOI: 10.1055/s-2000-8822
ORIGINALARBEIT
Georg Thieme Verlag Stuttgart · New York

Psychische Störungen bei körperlichen Erkrankungen

Mental Illness and Physical DisordersMartin  C. Härter
  • Universitätsklinik für Psychiatrie und Psychosomatik Freiburg, Abteilung Psychiatrie und Psychotherapie mit Poliklinik (Direktor: Prof. Dr. Matthias Berger)
Further Information

Publication History

Publication Date:
31 December 2000 (online)

Also available at
    Permissions and Reprints

Zusammenfassung

Sowohl aus klinischen Studien von Patienten mit spezifischen körperlichen Erkrankungen als auch von Patienten, die wegen einer psychischen Störung behandelt wurden, ist eine signifikante Assoziation zwischen psychischen Erkrankungen, insbesondere depressiven und Angststörungen, und somatischen Erkrankungen bekannt. Die korrekte Identifizierung der Komorbidität zwischen diesen Erkrankungen hat bedeutsame Implikationen für die Diagnostik, Behandlung und den Verlauf der psychischen und assoziierten somatischen Störungsbilder. Der Artikel gibt eine Übersicht über Studien und Reviews aus den letzten Jahren über die Komorbidität psychischer und ausgewählter medizinischer Erkrankungen (Tumor-, Herz-Kreislauf-Erkrankungen, endokrinologische und muskuloskelettale Erkrankungen). Methodische Fragen, Risikofaktoren, potentielle ätiologische Mechanismen und Konsequenzen für Diagnostik, Behandlung und die Planung zukünftiger Untersuchungen werden diskutiert.

Close association between mental disorders, e.g. depressive or anxiety disorders, and numerous physical diseases has been consistently reported in clinical studies of patients with specific medical disorders, as well as among persons undergoing treatment for mental disorders. Accurate classification of this comorbidity has major implications for diagnosis, treatment, and course of both the psychological disorders and concomitant somatic diseases. The article summarises studies and reviews of comorbidity of mental disorders and selected somatic conditions (oncological, cardiovascular, endocrinological, and musculo-skelettal disorders). Methodological issues, risk factors, possible mechanisms of comorbidity, and implications of these associations for diagnosis, treatment, and planning of future studies are described.

Key words

Comorbidity - Mental illness - Endocrinological disorders - Cardiovascular disease - Cancer - Musculo-skeletal disorders

Literatur

  • 1 Stevens D, Merikangas K R, Merikangas J R. Comorbidity of depression and other medical conditions. In: Beckham E, Leber W (eds.) Handbook of Depression. New York; Guildford Press 1995: 147-199
    Google Scholar
  • 2 Winokur G. The concept of secondary depression and its relationship to comorbidity.  Psychiatrics Clinics of North America. 1990;  13 567-583
    PubMedGoogle Scholar
  • 3 Woodruff R A, Murphy G E, Herjanic M. The natural history of affective disorders: 1. Symptoms of 72 patients at the time of index hospital admission.  Journal of Psychiatric Research. 1967;  5 255-263
    CrossrefPubMedGoogle Scholar
  • 4  American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington DC; American Psychiatric Press 1994
    Google Scholar
  • 5 World Health Organization. International Classification of Diseases (10th revision). Genf; World Health Organization 1992
  • 6 Cohen-Cole S H, Brown F W, McDaniel J S. Assessment of depression and grief reactions in the medically ill. In: Stoudemire A, Fogel BS (eds.) Psychiatric Care of the medical Patient. New York; Oxford University Press 1993: 53-69
    Google Scholar
  • 7 McDaniel J S, Musselman D L, Porter M R. et al . Depression in patients with cancer.  Arch of gen Psychiat. 1995;  52 89-99
    PubMedGoogle Scholar
  • 8 Musselman D L, Evans D L, Nemeroff C B. The relationship of depression to cardiovascular disease.  Arch gen Psychiat. 1998;  55 580-592
    PubMedGoogle Scholar
  • 9 Burke J D, Regier D A. Epidemiology of mental disorders. In: Talbott JA, Hales RE, Yudofsky SC (eds.) Textbook of Psychiatry. Washington DC; American Psychiatric Press 1998
    Google Scholar
  • 10 Tsuang M T, Tohen M, Zahner G EP. Textbook in Psychiatric Epidemiology. New York; Wiley-Liss 1995
  • 11 Weyerer S. Psychiatrische Epidemiologie. In: Freyberger HJ, Stieglitz RD (Hrsg.) Kompendium der Psychiatrie und Psychotherapie. 10. Aufl. Basel; Karger 1996: 46-56
    Google Scholar
  • 12 Dohrenwend B P, Dohrenwend B S, Schwartz Gould M. et al .(Eds) Mental illness in the United States. Epidemiological Estimates. New York; Karger 1980
    Google Scholar
  • 13 Kessler R C, McGonagle K A, Zhao S. et al . Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States.  Arch gen Psychiat. 1994;  51 8-19
    PubMedGoogle Scholar
  • 14 Leighton D C, Harding J C, Macklin D B. et al .The Character of Danger. The Stirling Country Study of psychiatric Disorder and sociocultural Environment, Vol. III. London; Basic Books 1963
  • 15 Robins L N, Regier D A. Psychiatric Disorders in America. The Epidemiological Catchment Area Study. New York; Free Press 1991
  • 16 Srole L, Langner T S, Michael S T, Opler M K, Rennie T AC. Mental Health in the Metropolis: The Midtown Manhattan Study. New York; McGraw Hill 1992
  • 17 Dilling H, Weyerer S, Castell R. (Hrsg.) Psychische Erkrankungen in der Bevölkerung. Stuttgart; Enke 1984
    Google Scholar
  • 18 Linden M, Maier W, Achberger M, Herr R, Helmchen H, Benkert O. Psychische Erkrankungen und ihre Behandlung in Allgemeinpraxen in Deutschland.  Nervenarzt. 1996;  67 205-215
    Google Scholar
  • 19 Schepank H. Erkrankungen in der Stadtbevölkerung. Eine tiefenpsychologisch-epidemiologische Feldstudie in Mannheim. Berlin; Springer 1987
  • 20 Schmidt M H. Fortschritte in der psychiatrischen Epidemiologie. Weinheim; VCH Gesellschaft 1990
  • 21 Arolt V, Driessen M, Dilling H. Psychische Störungen bei Patienten im Allgemeinkrankenhaus.  Deutsches Ärzteblatt. 1997;  94 1354-1358
    PubMedGoogle Scholar
  • 22 Weiffenbach O, Gänsicke M, Faust G, Maier W. Psychische und psychosomatische Störungen in der Allgemeinarztpraxis.  Münchner medizinische Wochenschrift. 1995;  137 528-534
    PubMedGoogle Scholar
  • 23 Wittchen H-U, Müller N, Storz S. Psychische Störungen: Häufigkeit, psychosoziale Beeinträchtigungen und Zusammenhänge mit körperlichen Erkrankungen. Unveröffentlichtes Manuskript. München; Max-Plank-Institut für Psychiatrie 1998
  • 24 Spitzer R L, Williams J, Gibbons M, First M B. Structured Clinical Interviews for DSM-III-R (SCID): History, rationale, and description.  Archives of General Psychiatry. 1992;  49 624-629
    PubMedGoogle Scholar
  • 25 Robins L N, Helzer J E, Croughan J, Ratcliff K. National Institute of Mental Health Diagnostic Interview Schedule: its history, characteristics, and validity.  Arch gen Psychiat. 1981;  38 381-389
    PubMedGoogle Scholar
  • 26 Wittchen H-U, Robins L N, Cottler L B, Sartorius N, Burke J D, Regier D. Cross-cultural feasibility, reliability and sources of variance of the Composite International Diagnostic Interview (CIDI) - Results of the multicenter WHO/ADAMHA field trials (Wave I).  British Journal of Psychiatry. 1991;  159 645-653
    PubMedGoogle Scholar
  • 27 Katon W, Sullivan M D. Depression and chronic medical illness.  Journal of Clinical Psychiatry. 1990;  51 (suppl.) 3-11
    PubMedGoogle Scholar
  • 28 Depression Guideline Panel. Depression in primary care: Volume 1, detection and diagnosis. Clinical practice guideline, Number 5.  Rockville; U. S. Department of Health and Human Services, Public Health Service, Agency for Health Care Policy and Research 1993
  • 29 Üstün T B, Sartorius N. (Eds) .Mental Illness in general health care. An International Study. Chichester; Wiley & Sons 1995
    Google Scholar
  • 30 Regier D A, Kälber C T, Rae D S. et al . Limitations of diagnostic criteria and assessment instruments for mental disorders. Implications for research and policy.  Arch gen Psychiat. 1998;  55 109-115
    CrossrefPubMedGoogle Scholar
  • 31 Arolt V. Psychische Störungen bei internistischen und chirurgischen Krankenhauspatienten - Diagnostik, Vorkommenshäufigkeit und Behandlungsindikation. Unveröffentlichte Habilitationsschrift. Lübeck; Med. Fakultät der Univ. Lübeck 1992
  • 32 Goldberg D, Jenkins L, Millar T, Faragher E B. The ability of trainee general practitioners to identify psychological distress among their patients.  Psychological Medicine. 1993;  23 185-193
    PubMedGoogle Scholar
  • 33 Ormel J, Koeter M WJ, Van den Brink W, Van de Willige G. Recognition, management, and course of anxiety and depression in general practice.  Arch gen Psychiat. 1991;  48 700-706
    PubMedGoogle Scholar
  • 34 Paykel E S, Tylee A, Wright A. et al . The Defeat Depression Campaign: Psychiatry in the public area.  Am J Psychiat. 1997;  154 (6) (Suppl.) 59-65
    PubMedGoogle Scholar
  • 35 Spitzer R L, Kroenke K, Linzer M. et al . Health-related quality of life in primary care patients with mental disorders.  JAMA. 1995;  274 (19) 1511-1517
    CrossrefPubMedGoogle Scholar
  • 36 Spiegel D. Cancer and depression.  British Journal of Psychiatry. 1996;  168 (Suppl. 30) 109-116
    PubMedGoogle Scholar
  • 37 Bukberg J, Penman D, Holland J C. Depression in hospitalized cancer patients.  Psychosomatic Medicine. 1984;  45 199-212
    PubMedGoogle Scholar
  • 38 Cavenaugh S, Clark D, Gibbons R. Diagnosing depression in the hospitalized medically ill.  Psychosomatics. 1983;  24 809-815
    PubMedGoogle Scholar
  • 39 Endicott J. Measurement of depression in patients with cancer.  Cancer. 1984;  53 (Suppl.) 2243-2249
    CrossrefPubMedGoogle Scholar
  • 40 Rifkin A, Reardon G, Siris S. Trimipramine in physical illness with depression.  Journal of Clinical Psychiatry. 1985;  46 4-8
    PubMedGoogle Scholar
  • 41 Spitzer R L, Endicott J, Robins E. Research diagnostic criteria.  Archives of General Psychiatry. 1978;  35 527-533
    PubMedGoogle Scholar
  • 42 Kathol R G, Mutgi A, Williams J, Clamon G, Noyes R. Diagnosis of major depression in cancer patients to four sets of criteria.  American Journal of Psychiatry. 1990;  147 1021-1024
    PubMedGoogle Scholar
  • 43 Creed F. Assessing depression in the context of physical illness. In: Robertson MM, Katona CLE (eds.) Depression and Physical Illness. Chichester; Wiley & Sons 1997: 3-19
    Google Scholar
  • 44 Mayou R A. Depression and types of physical disorders and treatment. In: Robertson MM, Katona CLE (eds.) Depression and Physical Illness. Chichester; Wiley & Sons 1997: 20-38
    Google Scholar
  • 45 Stoudemire A, Fogel B S, Gulley L R, Moran M G. Psychopharmacology in the medical patient. In: Stoudemire A, Fogel BS (eds.) Psychiatric Care of the medical Patient. New York; Oxford University Press 1993: 155-206
    Google Scholar
  • 46 Ford S, Lewis S, Fallowfield L. Psychological morbidity in newly referred patients with cancer.  Journal of Psychosomatic Research. 1995;  39 (2) 193-202
    CrossrefPubMedGoogle Scholar
  • 47 Lederberg M S, Holland J. Psycho-oncology. In: Kaplan HI, Saddock BJ (eds.) Comprehensive Textbook of Psychiatry. 6th edition. Baltimore u. a. O.; Williams & Wilkins 1995: 1570-1592
    Google Scholar
  • 48 Derogatis L R, Morrow G R, Fetting J. et al . The prevalence of psychiatric disorders among cancer patients.  JAMA. 1983;  249 751-757
    CrossrefPubMedGoogle Scholar
  • 49 Härter M, Kenk A, Reuter K, Wark S, Weis J, Marschner W. Comorbidity of cancer and mental illness.  Psychooncology. 1998;  7 (4, Suppl.) 47
    PubMedGoogle Scholar
  • 50 Lesko L M, Massie M J, Holland J. Oncology. In: Stoudemire A, Fogel BS (eds.) Psychiatric Care of the medical Patient. New York; Oxford University Press 1995: 565-590
    Google Scholar
  • 51 Shekelle R B, Ostfeld W J. Psychological depression and 17 year risk of death from cancer.  Psychosom Med. 1991;  43 117-125
    PubMedGoogle Scholar
  • 52 Wells K B, Golding J M, Burnam M A. Psychiatric disorder in a sample of the general population with and without chronic medical conditions.  Am J Psychiat. 1988;  145 976-981
    PubMedGoogle Scholar
  • 53 Katon W, Sullivan M, Clark M. Cardiovascular disorders. In: Kaplan HI, Saddock BJ (eds.) Comprehensive Textbook of Psychiatry. 6th ed. Baltimore; Williams & Wilkins 1995: 1491-1501
    Google Scholar
  • 54 Chignon J M, Lepine J P, Ades J. Panic disorder in cardiac outpatients.  American Journal of Psychiatry. 1993;  150 780-785
    PubMedGoogle Scholar
  • 55 Costa P T, Zonderman A B, Engel B T. et al . The relation of chest pain symptoms to angiographic findings of coronary artery stenosis and neuroticism.  Psychosom Med. 1985;  47 285-293
    PubMedGoogle Scholar
  • 56 Katon W, Hall M L, Russo J. et al . Chest pain: relationship of psychiatric illness to coronary arteriographic results.  Am J Med. 1988;  84 1-9
    PubMedGoogle Scholar
  • 57 Beitman B D, Muskerji V, Lamberti J W. et al . Panic disorders in patients with chest pain and angiographically normal coronary arteries.  Am J Cardiol. 1988;  63 1399-1403
    PubMedGoogle Scholar
  • 58 Herrmann Ch, Scholz K H, Kreuzer H. Psychologisches Screening von Patienten einer kardiologischen Akutklinik mit einer deutschen Fassung der „Hospital Anxiety and Depression” (HAD)-Skala.  Psychother Psychosom med Psychol. 1991;  41 83-92
    PubMedGoogle Scholar
  • 59 Levenson J L. Cardiovascular Disease. In: Stoudemire A, Fogel BS (eds.) Psychiatric Care of the medical Patient. New York; Oxdord University Press 1993: 539-563
    Google Scholar
  • 60 Carney R M, Rich M W, Freedland K M, Saini J. Major depressive disorder predicts cardiac events in patients with coronary artery disease.  Psychosomatic Medicine. 1988;  50 627-633
    PubMedGoogle Scholar
  • 61 Frasure-Smith N, Lesperance F, Tallajic M. Depression following myocardial infarction: impact on 6-month survival.  JAMA. 1993;  270 1819-1861
    CrossrefPubMedGoogle Scholar
  • 62 Gonzalez M B, Snyderman T B, Colket J T, Arias R M, Jiiang J W, O'Connor C M, Krishman K R. Depression in patients with coronary artery disease.  Depression. 1996;  4 57-62
    CrossrefPubMedGoogle Scholar
  • 63 Schleifer S J, Macari-Hinson M M, Coyle D A, Slater W A, Kahn M, Gorlin R, Zucker H D. The nature and course of depression following myocardial infarction.  Archives of Internal Medicine. 1989;  149 1785-1789
    PubMedGoogle Scholar
  • 64 Gala C, Galletti F, Invernizzi G. Depression and cardiovascular disease. In: Robertson MM, Katona CLE (eds.) Depression and Physical Illness. Chichester; Wiley & Sons 1997: 210-223
    Google Scholar
  • 65 Glassman A H, Shapiro P A. Depression and the course of coronary artery disease.  American Journal of Psychiatry. 1998;  155 (1) 4-11
    PubMedGoogle Scholar
  • 66 Hayward C. Psychiatric illness and cardiovascular disease risk.  Epidemiological Reviews. 1995;  17 129-138
    PubMedGoogle Scholar
  • 67 Friedman M, Thoresen C E, Gill J J. et al . Alteration of type A behaviour and its effects on cardiac recurrences in post myocardial infarction patients: summary results of the Recurrent Coronary Prevention Project.  American Heart Journal. 1986;  112 653-665
    CrossrefPubMedGoogle Scholar
  • 68 Rosenman R H. The interview method of assessment of the coronary-prone behaviour pattern. In: Dembrowski TM, Weiss SM, Shields SM, Haynes SG, Feinleib M (eds.) Coronary-prone Behavior. New York; Springer 1978
    Google Scholar
  • 69 Roskies E, Kearny H, Spevack M. Generalizability and durability of the treatment effects in an intervention program for coronary-prone (type A) managers.  Journal of Behavioral Medicine. 1979;  2 195-207
    CrossrefPubMedGoogle Scholar
  • 70 Shapiro P A, Glassman A H, Lesperance F. et al .Treatment of major depression after acute myocardial infarction with sertraline: a preliminary study.  In: Annual Meeting New Research Program and Abstracts. Washington DC; American Psychiatric Association 1996: 249-250
    Google Scholar
  • 71 Boswell E B, Anfinson T J, Nemeroff C B. Depression associated with endocrine disorders. In: Robertson MM, Katona CLE (eds.) Depression and Physical Illness. Chichester u. a. O.; John Wiley & Sons 1997: 255-292
    Google Scholar
  • 72 Farber N B, Black K J. Psychiatric disorders associated with general conditions. In: Guze SB (ed.) Washington University Adult Psychiatry. St. Louis u. a. O.; Mosby 1997: 407-433
    Google Scholar
  • 73 Kornstein S G, Gardner D F. Endocrine disorders. In: Stoudemire A, Fogel BS (eds.) Psychiatric care of the medical Patient. New York; Oxford University Press 1993: 657-678
    Google Scholar
  • 74 Goetsch V I, Wiebe D J. Diabetes Mellitus: Considerations of the influence of stress. In: Goreczny AJ (ed.) Handbook of Health and Rehabilitation Psychology. New York; Plenum Press 1995: 513-533
    Google Scholar
  • 75 Helz J W, Templeton B. Evidence of the role of psychosocial factors in diabetes mellitus: a review.  American Journal of Psychiatry. 1990;  147 1275-1282
    PubMedGoogle Scholar
  • 76 Gavard J A, Lustman P J, Clouse R E. Prevalence of depression in adults with diabetes - an epidemiological evaluation.  Diabetes Care. 1993;  16 1167-1178
    PubMedGoogle Scholar
  • 77 Popkin M K, Lentz A L. Prevalence of major depression, simple phobia, and other psychiatric disorders in patients with long-standing type I diabetes mellitus.  Archives of General Psychiatry. 1988;  45 64-68
    PubMedGoogle Scholar
  • 78 Lustman P J, Cluse L S. Psychiatric illness in diabetes mellitus: Relationship to symptoms and glucose control.  Journal of Nervous and Mental Disease. 1986;  174 736-742
    PubMedGoogle Scholar
  • 79 Lustman P J, Harper G W. Nonpsychiatric physicians' identifica-tion and treatment of depression in patients with diabetes.  Comprehensive Psychiatry. 1987;  28 22-27
    CrossrefPubMedGoogle Scholar
  • 80 Härter M, Berger M. Psychiatrische und psychosomatische Komorbidität bei Diabetes mellitus. In: Berger M (Hrsg.) Diabetes mellitus. München; Urban & Schwarzenberg 1999 (im Druck)
    Google Scholar
  • 81 Herpertz S, Albus C, Wagener R. et al . Comorbidity of diabetes and eating disorders.  Diabetes Care. 1998;  21 1110-1116
    CrossrefPubMedGoogle Scholar
  • 82 Flor H. Psychobiologie des Schmerzes. Bern; Hans Huber 1991
  • 83 Parker J C, Wright G E. Depression in arthritis and muskuloskeletal disorders. In: Robertson MM, Katona CLE (eds.) Depression and Physical Illness. Chichester u. a. O.; John Wiley & Sons 1997: 377-390
    Google Scholar
  • 84 Härter M. Psychosomatische Aspekte bei rheumatischen Erkrankungen.  Psychotherapie, Psychosomatik, medizinische Psychologie. 1993;  43 100-109
    PubMedGoogle Scholar
  • 85 Frank R G, Beck N C, Parker J C, Kashani J H, Elliot T R, Haut A E, Smith E, Atwood C, Brownlee-Duffect M, Kay D R. Depression in rheumatoid arthritis.  J Rheumatol. 1988;  15 920-925
    PubMedGoogle Scholar
  • 86 Creed F, Ash G. Depression in rheumatoid arthritis. Atiology and treatment.  International Reviews in Psychiatry. 1992;  4 23-34
    PubMedGoogle Scholar
  • 87 Mau W, Raspe H.-H. Das fibromyalgische Syndrom.  Wiener Medizinische Wochenschrift. 1990;  140 343-348
    PubMedGoogle Scholar
  • 88 Wolfe F, Smythe H A, Yunus M B, Bennett R M, Bombardier C, Goldenberg D L, Tugwell P. The American College of Rheumatology 1990: Criteria for the classification of fibromyalgia.  Arthr and Rheum. 1990;  33 160-172
    CrossrefPubMedGoogle Scholar
  • 89 Burkhardt C S, O'Reilly C A, Wiens A N, Clark S R, Campbell S M, Bennett R M. Assessing depression in fibromyalgie patients.  Arthritis Care Research. 1994;  7 35-39
    PubMedGoogle Scholar
  • 90 Hildebrandt J, Kaluza G, Pfingsten M. Rückenschmerzen. In: Basler H-D, Franz C, Kröner-Herwig B, Rehfisch HP, Seemann H (Hrsg.) Psychologische Schmerzbehandlung. Grundlagen, Diagnostik, Krankheitsbilder, Behandlung. Berlin; Springer-Verlag 1990: 302-327
    Google Scholar
  • 91 Flor H, Turk D C. Etiological theories and treatments for chronic back pain: I. Somatic models and interventions.  Pain. 1984;  19 105-121
    Google Scholar
  • 92 Cheatle M D, Brady J P, Ruland T. Chronic low back pain, depression, and attributional style.  The Clinical Journal of Pain. 1990;  6 114-117
    PubMedGoogle Scholar
  • 93 Flor H, Behle D J, Birbaumer N. Assessment of pain-related cognitions in chronic pain patients.  Behaviour Research and Therapy. 1993;  31 63-73
    CrossrefPubMedGoogle Scholar
  • 94 Härter M. Graduierung von Schmerzen und Funktionsein-schränkungen bei Erkrankungen am Stütz- und Bewegungsapparat. Ergebnisse einer epidemiologischen Untersuchung von Gesunden und Patienten mit Rückenschmerzen. Frankfurt; Peter Lang 1994
  • 95 Romano J M, Turner J A. Chronic pain and depression: Does the evidence support a relationship?.  Psychological Bulletin. 1985;  97 18-34
    CrossrefPubMedGoogle Scholar
  • 96 Van Houdenhove B, Onghena P. Pain and Depression. In: Robert-son MM, Katona CLE (eds.) Depression and Physical Illness. Chichester u. a. O.; John Wiley & Sons 1997: 465-497
    Google Scholar
  • 97 Waddell G, Main C J. Assessment of severity in low-back disorders.  Spine. 1984;  2 204-208
    PubMedGoogle Scholar
  • 98 Hasenbring M. Chronifizierung bandscheibenbedingter Schmerzen. Risikofaktoren und gesundheitsförderndes Verhalten. Stuttgart; Schattauer 1992
  • 99 Egle U T, Philipp M. Schmerz aus psychiatrischer Sicht. In: Egle UT, Hoffmann SO (Hrsg.) Der Schmerzkranke. Grundlagen, Pathogenese, Klinik und Therapie chronischer Schmerzsyndrome aus bio-psycho-sozialer Sicht. Stuttgart; Schattauer 1993: 78-90
    Google Scholar
  • 100 Magni G, Marchetti M, Moreschi C, Mersky H, Lucchini S R. Chronic musculoskeletal pain and depressive symptoms in the national health and nutrition examination. I. Epidemiologic follow-up study.  Pain. 1993;  53 163-168
    CrossrefPubMedGoogle Scholar
  • 101 Pilowsky I, Bassett D L. Pain and Depression.  British Journal of Psychiatry. 1982;  141 30-36
    PubMedGoogle Scholar
  • 102 Banks S M, Kerns R. Explaining high rates of depression in chronic pain: A diathesis-stress framework.  Psychological Bulletin. 1996;  119 95-110
    CrossrefPubMedGoogle Scholar
  • 103 Sullivan M JL, Reesor K, Mikail S, Fisher R. The treatment of depression in chonic low back pain: Review and recommendations.  Pain. 1992;  50 5-13
    CrossrefPubMedGoogle Scholar
  • 104 Flor H, Fydrich T, Turk D C. Efficacy of multidisciplinary pain treatment centers: A metaanalytic review.  Pain. 1992;  49 221-230
    CrossrefPubMedGoogle Scholar
  • 105 Robertson M M. Depression in neurological disorders. In: Robertson MM, Katona CLE (eds.) Depression and Physical Illness. Chichester u. a .O.; John Wiley & Sons 1997: 305-340
    Google Scholar
  • 106 Merikangas K R, Stevens D. Comorbidity of migraine and psychiatric disorders.  Advances in Headache. 1997;  15 115-123
    PubMedGoogle Scholar
  • 107 Collis I. Depression and respiratory disorders. In: Robertson MM, Katona CLE (eds.) Depression and Physical Illness. Chichester u. a. O.; John Wiley & Sons 1997: 391-405
    Google Scholar
  • 108 Smoller J W, Pollack M H, Otto M W, Rosenbaum J F, Kradin R L. Panic anxiety, dyspnoe, and respiratory disease.  American Journal of Respiratory and Critical Care Medicine. 1996;  154 6-17
    PubMedGoogle Scholar
  • 109 Thompson W L, Thompson T L. Pulmonary disease. In: Stoudemire A, Fogel BS (eds.) Psychiatric Care of the medical Patient. New York; Oxford University Press 1993: 591-610
    Google Scholar
  • 110 Levy N B. Chronic renal failure and its treatment: Dialysis and transplantation. In: Stoudemire A, Fogel BS (eds.) Psychiatric Care of the medical Patient. New York; Oxford University Press 1993: 627-635
    Google Scholar
  • 111 Sensky T. Depression in renal failur and in its treatment. In: Robertson MM, Katona CLE (eds.) Depression and Physical Illness. Chichester u. a. O.; John Wiley & Sons 1997: 359-375
    Google Scholar
  • 112 Kaplan M H, Feinstein A R. The importance of classifying initial co-morbidity in evaluating the outcome of diabetes mellitus.  Journal of Chronic Diseases. 1974;  27 387-404
    CrossrefPubMedGoogle Scholar

1 Zur Publikation vorgesehen in: Psychotherapie, Psychosomatik, medizinische Psychologie, 1999.

Dipl.-Psych. phil. Dr. Dr. med. Martin C. Härter

Universitätsklinik für Psychiatrie und Psychosomatik Abteilung Psychiatrie und Psychotherapie mit Poliklinik

Hauptstraße 5

79104 Freiburg

Email: Martin_Haerter@psyallg.ukl.uni-freiburg.de